Palliative & supportive care

We have a dedicated team of medical professionals who can support you and your family.

Palliative and supportive care is an approach that can help improve your quality of life and provide support to your family as a result of problems associated with a life-threatening illness.

What we do

Some examples of the services we provide are:

Pain management – including pain assessment, developing a plan of action and monitoring and controlling pain

Managing other symptoms that can occur, like fatigue and exhaustion, shortness of breath, cough, nausea and vomiting, loss of appetite and anxiety

Meetings with you and your family to discuss diagnosis, stage of illness, treatment options and care plans, including advance care planning

Physiotherapy, occupational therapy, social work, music therapy, pastoral care and other therapies

Making plans for care outside of the hospital – we can assist you in arranging physical and psychosocial supports for care at home

As part of the new Victorian Compressive Cancer Centre, The Royal Melbourne Hospital, Peter MacCallum Cancer Centre and The Royal Women’s Hospital are partnering to deliver a comprehensive and coordinated palliative care service across the Parkville Precinct.

Our clinicians and nursing consultants work across both Peter Mac and The Royal Melbourne Hospital as an integrated service. This means you may, from time-to-time, be seen by a new clinician or nursing consultant. Rest assured however that each member of our team will be fully apprised of your medical history and care plan.

What is palliative care?

The term palliative care is used to describe the care and support that is provided to people who have a life threatening illness. The World Health Organisation states:

Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is achievement of the best quality of life for patients and families.

Palliative care does not mean withdrawing all treatment. Indeed, very active interventions such as antibiotics, blood transfusions, and cancer treatments such as chemotherapy and radiotherapy may be helpful in alleviating symptoms and improving a patients’ quality of life. Where cure is unlikely or impossible, the goals of care change to focus on enhancing quality of life. Palliative care means that the patient’s comfort and dignity become the priority and adequate support is provided to them and their families and carers. It has been said that palliative care is about "adding life to years, not years to life".

At the RMH, who will be providing my care?

The ward is staffed by specialist doctors, nurses, and allied health professionals. You and your family will be cared for by a nurse who will introduce themselves each shift. Doctor’s rounds happen regularly and your care team is always available to speak with you if there are any concerns.

We care about what you think If you have any feedback, either good or bad, we would like to know – so we can improve the care we provide to all our patients. You may do this by speaking with any of our staff or you can complete our online survey (you can remain anonymous if you like).

If you wish to speak with someone from outside our service, please contact one of the hospital’s Consumer Liaison Officers.

The Palliative Care ward is open 24 hours a day, 7 days a week.

Is palliative care only for people with cancer?

No. Palliative care is available for all people facing life-limiting illnesses.

Where is care available?

Many families will move between these places of care listed below. It is important to understand that you can change your mind at any time during the course of illness. This is particularly important for those who choose home care. There will always be a bed available in the hospital ward if at any time you feel hospital care is more appropriate. Staff at the hospital are also available to provide guidance and advice regarding the care of patients at home and in the hospice.

Home

Many patients and families want to receive care at home because they feel secure there and are better able to control their daily routine. It also increases the opportunity for the families and carers to assist with care. Patients and their carers may find the support of a palliative care service helpful when they are at home. In Victoria, palliative care providers are located in the local community and have a range of services on offer for families including nursing, counseling, bereavement support, and in some cases complementary therapies such as music therapy and massage.

Hospital

While most symptoms can be readily controlled at home, some patients may need admission to hospital from time to time. Some families may feel uncomfortable or unable to care for their relative at home for various reasons. Hospital staff try, where ever possible, to provide a comfortable environment for the patient and family. Patients’ and families have access to the support of all members of the hospital's health care team including doctors, nurses, social workers and chaplains.

Hospice

Palliative care can also be provided in an inpatient palliative care unit or hospice. The emphasis is on addressing symptoms like pain and discomfort, and providing as best as possible care in a calm environment where family and friends are encouraged to be involved.

How do people cope?

When the question of palliative care is raised, you may feel confused, overwhelmed and frightened. You may experience many reactions - for example: shock, disbelief, a sense of unreality, numbness, sadness, fear, anxiety, anger, guilt, emptiness, hopelessness, helplessness, and other intense feelings. It is important for you to know that these feelings and thoughts are all experienced by many others and are not unexpected at such a difficult time.

Many experience great turmoil as a result of what are major changes. Sometimes find that their experience of the good days can be affected by the knowledge of their illness. It can be hard to balance everyone’s needs at the same time, including that of the patient and their families and carers. Some find it helpful to live one day at a time, to maintain some routine, and to also be flexible when making plans.

Helpful hints for you and your family

Do what is right and/or comfortable for you, and your family and carers, not what is expected of you

Continue to ask the questions that you need to for further understanding and clarification. Remember that no question is too small or too silly to be asked

It is OK for you to want to know everything or nothing, or only some things at a time

Let your treating health care team know when you are ready to talk about your illness progression, symptoms, timing of death, etc.

If you find it hard to talk about things, consider keeping a diary of your thoughts and feelings.

We all need the help and support of other people at some time in our lives - you will be able to help someone else at another time. It is your turn now to have support.

Do call on the supports available to help you. The following is a list of resources (not an exhaustive one) that you may wish to access for information, advocacy, emotional and practical support, and bereavement care.

What resources can I access?

Family and friends

Many patients feel that the greatest help they receive is the care and support given to them by their family and friends. One of the best things you can do at this difficult time will be to accept the help and support offered by those closest to you. Try not to shut them out. They will want to support you in any way they can, even if they don't know what to say or do. You may need practical help such as in preparing meals.

The hospital treating team

The health care professionals who may be involved in your care include doctors, nurses, social workers, occupational and physiotherapists, pastoral care and other allied health workers. To ensure that you are not overwhelmed with offers of assistance it is important that a member of the team take on the role of coordinator. You may request a coordinator to be appointed if this has not already happened.

Some families find it helpful to keep a note of all the people involved and their contact numbers, as well as questions they may wish to ask. Family meetings can also be organised for all the staff involved in your care as well as key family members. These meetings can be an information session to provide information about your medical condition, treatment options, ongoing supports and to prepare you for things that might happen. Alternatively, patients and families are encouraged to make times with individual staff members as needed.

Will I have to pay?

Most services are provided free of charge. There may be some cost for equipment (purchase or rental) and medications. Please ask us for details of any costs.

What services are available at The Royal Melbourne Hospital?

The palliative and supportive care unit

This is a 12 bed specialist unit located on level 7 West of the Royal Melbourne Hospital City Campus. Patients are admitted to the unit for a variety of reasons, including for management of complex pain, investigation and management of illnesses and other symptoms. Where possible, the unit assists patients to return to their home, with the support of community-based palliative care service providers. The unit is open 24 hours a day, every day.

The unit is staffed by a specialist team of medical, nursing and allied health staff, with visiting pastoral care and volunteer staff and a program of evidence-based Wellness therapies and programs.

Palliative care consultative service at The Royal Melbourne Hospital

The Palliative care consultancy team, consisting of medical and nursing consultants, is available to see patients on referral whether they be admitted to The Royal Melbourne Hospital City Campus or Royal Park Campus or attending an outpatient clinic.

The team can assist with managing patients' pain and symptoms, including emotional and spiritual distress, in conjunction with their treatment team, discharge planning, including linking in with community-based support services, and admissions to the Palliative Care Unit.

Palliative Care Outpatient Clinic

Patients can be seen by specialist medical staff in an outpatient setting. Written referrals must be received from the patient’s referring medical practitioner.

How to access this service

You need a referral from your GP or medical practitioner to access this service.

Your GP will fax your referral to the hospital. Once we receive the referral, we will send you a letter.